740451.pdfX
BUILDING DEPARTMENT Appll tFlu OHNE 915-7-10 NUMDEA
PERMIT APPLICATION I Inside Heavy Linesjo17��1 via
NAME (OR NAME OF BUSINESS) DRESS
PERMISSIBLE
LOT COVERAGE? S20, D � 1
M MAILING ADDRESS
.",9,9 7 7 _
ij AZ PERMISBIELE HEI B"
03.1•Y 6
TELEPHOR
NE NUMBER— ACTUAL LOT AREA T
Gtl.rl I P.4 _ 6 sa Q o o
1 REQUIRE170
YARDS
U
W
yF
S
U
1/o Ae,y7 —"
Y, ADDRESS
C CITY TE"PHO
�O�fe/yos . Gu A. /I
V STATE LICENSE NUMBER CITY LIC'.
i I—al Dee.r(¢tl.n at PreaertV (Show Below or Attach
NO
740451
1
HEAR
'REST VV //�� ^^ tp
USTI STREET R/♦ LL'1'r• EFICIENCY THIS PROPERTY X
COMP. PLAN ST. R/vo/off'. .. ...FT. ra
EMARKS Driveway slopes
r� not to exceed those o
dicated on StandardiDwa. 10"i w
NO
tlYFn:lAL 1NtlYr:U'rV CVUIKGL UUI:UYA3VVY U1tVUY I
0 YES NO
6Al.�
��7�7((�'fr
REBfDENTIAL LINE
PLAN CHECKED BY
IN CITY
I
IJII NEW
THIS SITE IS LOCATED THE
SALES TAX
X
BUILDING DEPARTMENT Appll tFlu OHNE 915-7-10 NUMDEA
PERMIT APPLICATION I Inside Heavy Linesjo17��1 via
NAME (OR NAME OF BUSINESS) DRESS
PERMISSIBLE
LOT COVERAGE? S20, D � 1
M MAILING ADDRESS
.",9,9 7 7 _
ij AZ PERMISBIELE HEI B"
03.1•Y 6
TELEPHOR
NE NUMBER— ACTUAL LOT AREA T
Gtl.rl I P.4 _ 6 sa Q o o
1 REQUIRE170
YARDS
U
W
yF
S
U
1/o Ae,y7 —"
Y, ADDRESS
C CITY TE"PHO
�O�fe/yos . Gu A. /I
V STATE LICENSE NUMBER CITY LIC'.
i I—al Dee.r(¢tl.n at PreaertV (Show Below or Attach
NO
740451
1
HEAR
'REST VV //�� ^^ tp
USTI STREET R/♦ LL'1'r• EFICIENCY THIS PROPERTY X
COMP. PLAN ST. R/vo/off'. .. ...FT. ra
EMARKS Driveway slopes
r� not to exceed those o
dicated on StandardiDwa. 10"i w
NO
tlYFn:lAL 1NtlYr:U'rV CVUIKGL UUI:UYA3VVY U1tVUY I
0 YES NO
6Al.�
��7�7((�'fr
REBfDENTIAL LINE
PLAN CHECKED BY
IN CITY
IJII NEW
THIS SITE IS LOCATED THE
SALES TAX
NON•REBIDENTIAL BIG�r
OF EDMONDS. LOCAL
BE CODED 31.04.
ADD
REMARKS
SHOULD
I.
DEMOLISH ❑ W^'IAININC
❑ ALTER EXCAVATE FENCE
OR FILL (.....'....x..........Ft.)
I
Ej REPAIR PRE -MOVE ❑ BtVIM
C p -...�
✓
❑ INSP. PO
L
J
NUMBER OF STORIES NUMBER OF
2 DWELLING /
UNITS
l
V""""Fec Receipt No. j
NATURE OF RK TO HE
'&/� 9—
Plnn Check No.....................
! !
1
[O�
BUILDING
j
"T�10-7/'01
4 PROPOSED USE
�0.
PLUMBING
GG
U
i
PLOT PLAN (Indicate Building ectbauks, abutting streets)
HEAT d: OAS LINE
J
9
FENCE
1
SIGN
1
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE•MOVE INSPECTION
EXCAVATION OR FILL
I'
TOTAL AMOUNT DUE
I hereby nck...I,dg. that I have read thla appll"H"
thnI the In.
pG(
tormatlon given le correct; and that I am the owner, or the
duly author-
Ired agent of the owner. I agree to comply will city and ata
a Iowa regu•
ATTENTION
APPLICATION APPROVAL
taring conotructlon; and In doing the work authorlaed there
Y. no Dano.
will be employed In A.I. lo. of the Labor Code of the Slate of
Wmhlagton
THIS PERMIT
This application Is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except I)EMOLI�'IONH
which
IE-„__---'
µ•ONLYORK NTOTED
Uty; and fees are pard, and receipt isne-
ehall be completed In ninety dnya; MOVED -IN BUILDINGS Abell
be in.
knowledged in space provided.
pleted In alx months.)
SIGNED
INSPECTION
DI E 8 SIGNAT RE
SIGNATURE (OWNER DATE
/O,R JAGENT)
DEPARTMENT
-•'�/ jI
CITY OF
EDDIONDSFAY
NOTE: Applicant Subject to Plan Check
fee
ONLY.
775-2525
3- '
Thle I'emnt cot'en work to be done an Driv.le proMrl
Any conatrucllen an the public domain (curbs, eldew'Wka,
rl•ewaye,
FILE '
n, r,; r�, rir.1 illi "..,d_nrimrnlr prrml�elon.
I
USE "rPERMIT
BUILD I N G DEPJ R T M E N T Applicant FIU ZONEI' r- �? NUMBER j
PERMIT APPLICATION Inside heavy Lines JOB
ADDRESS �I ,. •� ,./ "• % (/' /
NAME (OR NAME OF BUB NESS)
" - PER.f Idd10LE / ACTUAL
I •1 C/•�',ti, ��- /.F F._ f- ,/ LOT COVERAGE %ilI LOT COVERAGE rt/ / I !
M MAILING ADDRESS -� 1 0
PERMISSIBLE HE FIT PROPOBHD 11 GRT
O CITY' f ACTUAL LOT AREA � TOTAL SLI)O ARE
TELEPHONE NUMBER ((
i.-, /✓/ J 1,.,.' 1 REgUIRED YARDS
NAME FRONT SIDE REAR FRONT SIDE/ REAR
LEGAI-LO'ed," VARIANCE OR CONDITIONAL U§E
ai ADDRE88 E3 YES' [] NO PERMIT NUMBER
-PLANrylIj6 DEPT. AYPR01(AL _ DATE: 7
tq CITY TELEPHONE. NUMBER
< STREETET RW!
/w i••
EkISTINd STREET R/Wl".7 (W, I)(EFICIENCY THIS PROPER
NAME / COMP PLAN ST R/Wpi�j/�.(•PT ••• FT
% r
REMARKS
.^•'7C
C.
ADDRESS L
p , _ /- ,Ir'' (.'t• ^t r,l..I .A F)w 1112 p2 ,
CHEC/
�K D Y
TY / TE���LEPHONE NUMBER
CI /
"tom I -"� r�/CJ METER SIZE BERV3CE SIZE CLEARANCE CHECKED BY ')
O STATE ,LICENSE NUMBE L CITY LICENSE NUMBER m
/
- 41
REMARKS
Legal Description o[ Pr.Va-ty (Show Below or Attach Four Copies) • ,
/TYPE CONNECTION 'VERIFIDqq BY' "' !
i, - / Jjf '� �• PERC. TEST - PER .T.1U fBER a
I
n I W I
REMARKS � I
J
1�
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED ? '
❑ YES 0 NO ty
SPECIAD-INSPEGTOR'REgU2 ED IOCCUPANCY GROUP 1
\, GA9 ❑ YES �]"NO % %
E• ESIDENTIAL ❑ LINE PLAN CHECKED BY THIS SITE IS to
IN THE CITY
NEW I'" -ION -RESIDENTIAL Blcx OF EDMONDS. LOCAL SALES TAX
LJ SHOULD I CODED 31.04.
ADD ❑ DE.SOLI9H ❑ yALL NINC REMARKS
❑ALTER EXCAVATE El FENCE
❑ OR FILLC.........x.......... Vt.) l..•.. � '
F] REPAIR PRE -MOVE SW3.f
❑ INSP. POOL -
NUMBER OF STORIES NUMIIER OF �''J " .... " / '� (/:•'' -// •,''� -
:7 DWELLING /
.._. UNITS f
NATURE OF WORK TOIBE DONE V.W.U.. Fee Receipt No.
1
Plan Check No ..................... I
[O BUILDING
W PROPOSED USE r "'
PLUMBING .I
4a1 PLOT PLAN (Indicate B (Wing setbacks, abutting streets) HEAT k GAB LINE ,
O L' I� FENCE
l SIGN
i
RETAINING HALL
N I I
j SWIMMING POOL i.
DEMOLITION — II
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledgi that I have read this application; that the In- .
formation given Is correct and that I art the owner, or the duly author.
lied agent of the owner. agree to comply with city and state law. regu- ATTENTION APPLICATION APPROVAL '
lallpg construction; and It dol.g the work authorized thereby, no person
Will be employed In violation of the Labor Code of the Slate of Washington THIS PERMIT This application is not a permit until
relating to Workmen'. Co peneatmi, Insurance. AUTHORIZES
ONLY Tsigned by the Building Official or his Dep -
NOTE: Permit Lim' One Year (Except DEMOLITIONfl Which WORK NOTEDILE uty; and fees are paid, and receipt is ae-
ahall be completed In Tn y days; MOVED -IN BUILDINGS .hall be com- lulowledged in space provided.
pieted In .1. months,)
SIGNATURE (OWNER OR AGE I DATE BIONED INSPECTION DIRECTOR'S S10NATURE/
DEPARTMENT
CITY OF t
EDMONDS
NOTE AAppl cant Subject to Plan Check Fee D
775-2525
This Permit em'ernwork lu bo done on private property ONLY.
Any construction on t11� public domain (curbs, sidewalks, drh'ewaye= - INSPECTOR -
marquee., el ) will require separate permis.l.n. - _